By Joanna Chakerian
Special to The Washington Post
Tuesday, February 24, 2009

In one "Grey's Anatomy" episode, doctors asked the parents of a svelte girl why she had gone to Mexico for gastric bypass surgery, a procedure that helps very obese people lose weight. The mother piped up that finding a way to lose weight had been her idea -- after the mother "had to take [her daughter] out and buy her a brand-new pair of size 6 jeans because she couldn't get in the ones I got her last summer."

I recognized that fictional scene. When I was 20 and a normal body weight by doctors' standards, my mother told me, "You would look so great and would be happier if you lost about 15 pounds." Her advice stuck. For three years, I battled bulimia, bingeing and vomiting. It was a long road to recovery, and while my mother was nowhere near as callous as the TV mom, the legacy of her well-intentioned concern about my weight has stayed with me.

Not all eating disorders are triggered by parents, but experts increasingly recognize the dangerous role of thinness-obsessed adults. Miles Goldstein, a therapist at the Eating Disorders Center of Potomac Valley, based in Rockville, advises most parents not to address weight issues.

"For all of us, our weight fluctuates," he says. "You've got to take into account what's going on on a psychological level, on an activity level, and there's certain years where there's going to be a lot more stress. If you're uncomfortable with your child's current weight fluctuation, I would definitely say ride out the wave: Don't bring it to the individual's attention."

Guidance for parents is available from a range of sources, including Web sites (such as http://www.empoweredparents.com, created by Abigail Natenshon, a Chicago area psychotherapist in the treatment of eating disorders) and support groups. Ashley Duque Kienzle, 26, a program director in the public relations and corporate communications graduate program at Georgetown University and a recovered bulimic, hears a lot about parental influence at the eating disorder therapy group she leads at McLean Bible Church in Vienna.

"I know a lot of women who have confronted their parents," she says. "You make them [the parents] aware of their behaviors that hurt you and ask them to try to diminish those." She said that one of the other group leaders realized the destructive role her mother's calorie-counting had played in her disorder only after she sought help at Remuda Ranch, a treatment center in Arizona.

Last year, a Philadelphia area nonprofit called A Chance to Heal began a series of workshops in which counselors, therapists and nutritionists talked to parents about easing up on their children regarding their appearance. Jane Shure, a family therapist on the group's board, said the meetings have attracted a strong response, with up to 50 people attending.

The first step toward easing up on their children is for parents to become aware of their own feelings about body image. On the parenting Web site Babble (http://www.babble.com), Jeanne Sager, a recovering bulimic, wrote last year that her toddler had caught her purging.

"Throwing up for me was always about control -- control of my weight on the surface, but control of the underlying issues that I always thought were created by my weight. I wasn't comfortable in my skin," Sager wrote in an e-mail. "It's not a nice feeling, and definitely not one I'd want to pass on to my daughter. I want her to be a strong, confident woman one day, a woman who loves who she is."